Clinical Presentation and 6-Month Outcomes of Patients with Peripartum Cardiomyopathy in Indonesia

Figures & data

Table 1 Baseline Characteristics of Patients with Peripartum Cardiomyopathy in Indonesia

Variables	Number of Patients	Values
Age	138	30.4 ± 6.4
BMI	138	25.3 ± 5.8
Obesity, n (%)	138	26 (18.8)
Weight group, n (%)	138
Underweight		13 (9.4)
Normal		66 (47.8)
Pre-Obese		33 (23.9)
Obese I		15 (10.9)
Obese II		8 (5.8)
Obese III		3 (2.2)
Educational status, n (%)	138
Primary		20 (14.5)
Secondary		41 (29.7)
High school		60 (43.5)
College or university		17 (12.3)
Income, n (%)	138
Low income		80 (58)
Middle income		57 (41.3)
High income		1 (0.7)
Smoking status, n (%)	138
Former		11 (8)
Current		0 (0)
Never		127 (92)
Alcohol, n (%)	138	5 (3.6)
Parity, n (%)	138
Primipara		39 (28.3)
Multipara		94 (68.1)
Grande multipara		5 (3.6)
History of PPCM, n (%)	138	4 (2.9)
Co-morbid, n (%)	138
Diabetes mellitus		0 (0)
Hypertension		77 (55.8)
Hypertension in pregnancy		27 (19.6)
Preeclampsia		84 (60.9)
Physical examination
Systolic blood pressure	137	133 ± 22.7
Diastolic blood pressure	137	86.6 ± 14.8
NYHA functional class	137
I		67 (32.8)
II		14 (6.9)
III		41 (20.1)
IV		82 (40.2)
Electrocardiography
Sinus rhythm, n (%)	138	138 (100)
Heart rate (bpm)	129	105.4 ± 20
QTc using Bazett formula (msec)	127	495.5 ± 82.9
QTc using Fridericia formula (msec)	127	455.5 ± 73.8
LBBB, n (%)	129	2 (1.6)
LVH, n (%)	129	44 (34.1)
Chest radiography
Cardiomegaly, n (%)	69	66 (95.7)
Alveolar oedema, n (%)	69	32 (46.4)
Pulmonary congestion, n (%)	67	37 (55.2)
Laboratory
Haemoglobin (mmol/L)	118	7.28 ± 1.14
HbA1c (%)	41	5.1 ± 0.89
Creatinine (µmol/L)	115	82.82 ± 33.09
Urea (mmol/L)	119	12.5 ± 8.6
Echocardiography
EF (%)	131	32.6 ± 7.5
LVEF	131
≤ 25%		16 (12.2)
26–35%		67 (51.1)
≥ 36%		48 (36.7)
LVEDd (mm)	130	55.2 ± 7.4
LVESd (mm)	129	46.3 ± 7.6
IVSDd (mm)	128	10 ± 5.9
IVSSd (mm)	128	11 ± 5.5
Atrial size (mm)	124	38.6 ± 6.5
Mitral regurgitation, n (%)	116
None		42 (36.2)
Mild		57 (49.1)
Moderate		15 (13)
Severe		2 (1.7)
Pulmonary hypertension, n (%)	115
None		42 (36.5)
Mild		45 (39.1)
Moderate		18 (15.7)
Severe		10 (8.7)
LV dilatation, n (%)	134	72 (53.7)
LV diastolic dysfunction, n (%)	96
None		4 (4.2)
Fusion		7 (7.3)
Grade I		9 (9.4)
Grade II		56 (58.3)
Grade III		20 (20.8)
RV function, n (%)	129
Normal		92 (71.3)
Mildly reduced		1 (0.8)
Reduced		34 (26.4)
Severely reduced		2 (1.5)
Time of PPCM diagnosis, n (%)	138
Prepartum		73 (52.9)
< 1 month post-partum		18 (13)
1 month post-partum		25 (18.1)
2–3 months post-partum		17 (12.3)
4–6 months post-partum		3 (2.2)
>6 months post-partum		2 (1.5)
Medications, n (%)
Beta-blocker	123	110 (89.4)
Alpha-blocker	123	3 (2.4)
CCB	123	6 (4.9)
ACEi/ARB	123	122 (99.2)
Diuretic	123	117 (95.1)
MRA	123	31 (25.2)
Bromocriptine	128	18 (14.1)
Digoxin	123	7 (5.7)
Anticoagulant	123	11 (8.9)

Abbreviations: ACEi, angiotensin-converting enzyme inhibitor; ARB, angiotensin receptor blocker; BMI, body mass index; HF, heart failure; IVSD, interventricular septal end diastole; LA, left atrium; LVH, left ventricular hypertrophy; LVEF, left ventricular ejection fraction; LVEDD, left ventricular end diastolic diameter; LVESD, left ventricular end systolic diameter; LV, left ventricle; MRA, mineralocorticoid receptor antagonist; NYHA, New York Heart Association; PPCM, peripartum cardiomyopathy; QTc, corrected QT; SBP, systolic blood pressure; TAPSE, tricuspid annular plane systolic excursion.

Figure 1 The main results of PPCM registry of Hasan Sadikin General Hospital, West Java, Indonesia.

Table 2 Obstetric and Neonatal Outcomes of Patients with Peripartum Cardiomyopathy in Indonesia

Variables	Number of Patients	Values
Obstetric outcomes
Twin pregnancy, n (%)	138	10 (7.2)
Breastfeeding, n (%)	138	93 (67.4)
Ante-partum diagnosis, n (%)	138
Abortion		14 (10.2)
Vaginal delivery		106 (76.8)
Caesarean section		18 (13)
Post-partum diagnosis, n (%)	138
Abortion		1 (0.7)
Vaginal delivery		72 (52.2)
Caesarean section		65 (47.1)
Neonatal outcomes
Death, n (%)	138	7 (5.1)
Male, n (%)	138	78 (56.5)
Birth weight (gram)	129	2630 ± 690
Birth weight classification	129
Normal weight (≥ 2500 gram)		79 (61.2)
Low birth weight (1500–2499 gram)		41 (31.8)
Very low birth weight (<1500 gram)		9 (7)
Birth length (cm)	122	46.6 ± 3.7
Head circumference (cm)	25	33.3 ± 5.4
APGAR 1 minute	52	6.5 ± 1.6
APGAR 5 minutes	52	8.5 ± 1.7

Abbreviation: APGAR, Appearance, Pulse, Grimace, Activity and Respiration.

Table 3 6-Month Outcomes of Patients with Peripartum Cardiomyopathy in Indonesia

Variables	Number of Patients	Values
Death, n (%)	134	9 (6.7)
Recovery, n (%)	94	63 (67)
Rehospitalization, n (%)	103	2 (1.9)
Thromboembolic complications, n (%)
DVT	105	0 (0)
PTE	105	0 (0)
Stroke haemorrhagic	105	0 (0)
Stroke non haemorrhagic	105	0 (0)
NYHA functional class, n (%)	92
I		72 (78.3)
II		20 (21.7)
III		0
IV		0
Echocardiography
LVEF (%)	94	52.6 ± 11.2
LVEF	94
≥50%		63 (67)
36–49%		24 (25.5)
≤ 35%		7 (7.4)
LVEDd (mm)	91	51.7 ± 6.3
LVESd (mm)	91	38.1 ± 7.9
Mitral regurgitation, n (%)	87
None		68 (78.2)
Mild		17 (19.5)
Moderate		1 (1.15)
Severe		1 (1.15)

Abbreviations: LVEF, left ventricular ejection fraction; LVEDD, left ventricular end-diastolic diameter; LVESD, left ventricular end-systolic diameter; NYHA, New York Heart Association.